The Danish polyposis register

A manual Danish register of patients with familial polyposis coli and their family members was established in 1971. The methods of collection of propositi, preparation of pedigrees, collection of call-up cases, and the organization of the register are described. A country-wide prophylactic proctosigmoidoscopic examination of first-degree relatives, aged 10 to 59 years, resulted in the detection of 42 call-up cases and by December 1982, 319 cases of polyposis were registered in 94 families. An evaluation of the number of collected propositi and call-up cases shows almost complete registration. Dr. Bülow has received grants from the Danish Cancer Society (809/71 and 87/80), “Max and Anna Friedmanns Legat,” and “Ferdinand og Ellen Hindsgauls Fond.”     

The French pacemaker register

The European ID card is the basis for the national registers of pacemaker wearers. The French register, dating from 1986, currently groups 2/3 of implantations or replacements performed each year in France. Year to year comparisons allow measurement of the indications for implanting and the equipment implanted, pacemakers as well as electrode probes. This allows an epidemiological approach which is particularly important since the advent of new equipment and new techniques such as multisite pacing. Within the framework of equipment surveillance and pacing surveillance, the French register could also lead to an important role.     

The establishment of a polyposis register

Guidelines are presented for the establishment of a regional or national register of patients with familial adenomatous polyposis. The detailed recommendations are based on the work in committees of the Leeds Castle Polyposis Group and the EuroFAP. The aims of national and regional polyposis registers are discussed, and the stages of development of a register are reviewed: Ascertainment of probands, construction of pedigrees, identification of family members at risk, and screening of members at risk. The problem of data confidentiality is discussed.

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Résumé Les consignes sont présentées pour l'établissement d'un registre Régional ou National des patients avec polypose adénomateuse familiale. Les recommandations détaillées sont basées sur les travaux des comités du Leeds Castle Polyposis Group et de EuroFAP. Les buts des registres Régionaux ou Nationaux des polyposes sont discutés et les stades de développement du registre sont passés en revu: l'assurance de probande, la construction de l'arbre généalogique, l'identification des familles des membres à risques et l'étude des membres à risques. Le problème de la confidentialité des faits est discuté.

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This paper is based on a report from committees of the Leeds Castle Polyposis Group and the EuroFAP.     

The British Society for Rheumatology biologics register

The British Society for Rheumatology (BSR) established a nationwide register for patients with rheumatological disorders treated with biologic agents. The register is designed as a national prospective study whose primary purpose is to assess long term toxicity from the use of these agents in routine practice. In addition, the data will be capable of addressing the benefits from their use in relation to their toxicity. One specific feature of the BSR register is the recruitment and collection of data from a parallel comparison group, comprising patients with active rheumatoid arthritis treated with conventional disease modifying agents. Both class specific and drug specific analyses of the group treated with biologicals are planned.     

Clearinghouse: partner notification

Eleven articles from professional magazines and journals are referenced on the subject of notifying the partners of HIV-infected individuals. Topics include self-disclosure of HIV infection to partners, and the benefits and risks of reporting HIV-infected individuals by name. Contact information is provided.     

Incisional hernia after surgery for colorectal cancer: a population-based register study

Background

Our knowledge on the incidence of incisional hernia and risk factors for developing incisional hernia following surgery for colorectal cancer is far from complete.

Methods

All procedures registered in the Swedish Colorectal Cancer Register (SCRCR) 2007–2013 were identified. Patients with comorbid disease diagnoses, registered at admissions and visits prior to the procedure and relevant to this study, were obtained from the National Patient Register (NPR). These diagnoses included cardiovascular disease, connective tissue disorders, liver cirrhosis, renal failure, diabetes, chronic obstructive lung disease and chronic inflammatory conditions. Data on occurrence of incisional hernias were obtained by combining data from the SCRCR and the NPR (International Classification of Diseases code).

Results

During 2007–2013, 39,984 procedures were registered in the SCRCR. After excluding laparoscopic procedures, procedures repeated on the same patient, procedures with concomitant liver resection and procedures without laparotomy, 28,913 cases remained for analysis. Five years after surgery, the cumulative incidence of incisional hernia was 5.3%. In multivariate proportional hazard analysis, significantly increased risk for incisional hernia was found for the male gender (hazard ratio [HR] 1.40, 95% confidence interval [CI] 1.21–1.62), operation time exceeding 180 min (HR 1.25, CI 1.08–1.45), body mass index (BMI) >?30 (HR 1.78, CI 1.51–2.09), age <?70 years (HR 1.34, CI 1.16–1.56) and postoperative wound complication (HR 2.09, CI 1.70–2.58).

Discussion

Men, patients younger than 70 years and patients with BMI?>?30 face a higher risk for incisional hernia. The risk is also increased in cases where the procedure takes longer than 3 h or where postoperative wound complications occur. These patients will benefit from measures aimed at preventing the development of incisional hernia.

     

Partner notification requires unique skills

The success of health care workers involved in partner notification depends greatly on accepting unusual working conditions and developing unique skills. According to Katharyn Waldron, MA, HIV educator at the University of Pittsburgh, the challenge is one of both educating and gaining trust. The payoff is that people may make life-changing decisions because they are able to see beyond the day-to-day needs of another fix or trick. She suggests dressing appropriately for the locale and being concerned about safety. Many partners often want to know who gave the health care worker their name. Confidentiality works both ways--protect the identity of the index partner as well as the other partner. To persuade HIV-positive partners to share information about contacts, she suggests avoiding blame and appealing to their sense of compassion and fairness. Providing prevalence statistics for the contact's community can help in educating individuals. Also provide basic information about HIV transmission and prevention, and assure availability for further contact.     

The responsibility of the transfusing physician

In a chronological representation a survey of important duties of the transfusing physician in blood transfusions is given. When fulfilling conscientiously the special, legal and organisational demands, the transfusing physician may authoritatively influence the decrease of disturbances of transfusion.